Dr Tim answers questions about depression, the effects of alcohol on mental health and anti-depressants
Dr Tim Anstiss, health and wellbeing improvement specialist at The Academy for Health Coaching will be joining us on BlackDogTribe.com every day this week between 4pm and 5pm to answer questions around depression, mental health and wellbeing from the community.
Below are the questions and answers from Monday 23 April:
I've been struggling with depression since 2008. My husband has a very difficult time dealing with my depression. I've been very communicative. Is there anything else I can do? - Anonymous
Sorry to hear about your struggle and the stress it may be causing with others. There may be many reasons for people to have a difficult time with their partner’s depression. They may be frustrated that the relationship has changed, they may interpret aspects of the depression as meaning that the person doesn't care for them or love them anymore, they may be cross with the person for not doing more for themselves or not 'snapping out of it', and they may miss the fun and pleasure that they used to have together - especially if the depressed person has lost interest in things, including perhaps sex. The impact of a person’s depression on others around them is part of what makes this condition so disabling and painful, for all concerned. Letting people know about how you are feeling is commonly helpful, but sometimes it makes other people feel helpless. They just do not know what to do to help, and they find that frustrating and may sometimes get angry. Empathy and acceptance are generally good emotions to experience and its sounds like you have empathy for your partner. For some depressed people helping your partner understand that it is nothing personal (however much it might feel that way to them) might be helpful. We also know that behavioural approaches can be helpful in depression, and starting to schedule in activities that you used to enjoy doing, even if you are not motivated to do them right now, can also help with the recovery process - things you used to enjoy doing together which perhaps you have stopped doing.
I feel fine, is it safe to come off my medication? - Anonymous
Possibly, but perhaps not if you have only been on them for a few weeks and best to do it under the guidance of a health professional. We now tend to think of depression as not just an acute, short term illness, but also - for some people - a long term condition which may come back. That is why clinicians commonly recommend people stay on their medication for several weeks or months even when they are feeling better. We also know that there are some approaches which can help people who have become 'undepressed' reduce their chances of having another episode. Skills based approaches which help you change the way you think, and even change the relationship you have with your thoughts and feelings. These are called cognitive-behavioural approaches, and some newer approaches based on mindfulness called, unsurprisingly, mindfulness-based CBT (cognitive behavioural therapy). So, talk with a health professional before you stop, and perhaps consider doing stuff to reduce that chances that you will have another episode. Your GP or community mental health team will be able to suggest local groups and classes.
Hi, I've been on prescribed anti-depressants now for 2 years. Just of late I've started to feel as low as I did before I started them. Is it possible that they stop having a long term effect on my feeling well? Whilst I have no idea what I would talk about should I be asking to speak to a counsellor? - Andrew
Sorry to hear that your symptoms are returning. It certainly sounds like your medications are not working as well as they used to. It may be worthwhile talking with someone, but your first port of call might be your GP or whoever put you on the medication in the first place. They may suggest a change in type of medication, or dosage. And many people do benefit from counselling and psychotherapy - but there are many different approaches out there and the field is not as well controlled as it might be. Your GP or practice nurse will be able to suggest counsellors and therapists they know and trust, and the government has put a lot of money into making psychological therapy more accessible, so hopefully you won't have to wait too long if you decide that option is for you. And don't worry about not knowing what to talk about, just see how it goes. Of course, increasing your level of physical activity can also help, and for some people this is an effective way of b becoming undepressed. But if you haven't been active for a while or have a health problem that might be made worse by exercise, again talk with your GP first.
Can drinking alcohol at a very young age have any effect on going on to develop depression? Personal experience: was given sweet sherry from age of four, wine and lemonade with meals from seven, broke my arm when drunk at 11. Parents thought they were teaching me responsible drinking. I had my first episode of depression aged 11 - 13, just prior to developing anorexia. Intermittent depression ever since. Became curious about effect of booze on developing brain when I recently decided to kick alcohol. - Jenny
There is a known association between alcohol and depression… Some people feel excited when they drink alcohol. Alcohol is actually a depressant but it can knock off the inhibitory part of the brain first which is why some people may feel less anxious after drinking. However many people do experience depression as a result of drinking too much and of course this can then lead to a vicious cycle in which their unhappiness leads to excessive drinking and their excessive drinking leads to unhappiness. Generally speaking if you are depressed it is probably best to minimise your intake of alcohol and discover more healthy ways of dealing with negative thoughts and feelings. Of course that is not to answer your specific question which is about the effects of alcohol on the brain in young people. Certainly we should all be encouraging sensible drinking but it does rather sound like your brain was exposed to too much alcohol at a too early an age. Let me do some more research on the impact of alcohol on a developing brain and I will post again when I have more information over the course of the next few days.